Clinical Studies

EDWARD L. EYERMAN, MD Journal of Neuroimaging June 1998 A new decompression table system applying fifteen 60 second tractions of just over one half body weight in twenty one-half hour sessions was reported to give good or excellent relief of sciatic and back pain in 86% of 14 patients with herniated discs and 75% of patients with facet joint arthritis.

Low back pain is one of the most common problems treated by orthopedic surgeons. Eighty percent of adults will experience significant low back pain sometime during their life. Second to the common cold, problems caused by the lower back are most frequent cause of lost workdays in adults under the age of 45.

RESEARCH SYNOPSIS

1) Bogduk, N,: The Anatomical Basis for Spinal Pain Syndromes. JMPT 6:Nov.Dec1995. There is no scientific basis for the belief muscles are a source of chronic pain. However controlled studies show how common disc and facet pain is accounting for more than 70% of chronic back pain.

Among patients who had reported limited activities before treatment, 78% reported improved activities.

On a scale of 0-3 the average satisfaction with treatment was 2.4, meaning “very satisfied” to “completely satisfied” with their treatment.

The study’s authors concluded that this treatment should be used for everyone with the above diagnoses and for patients that have had previous surgery and are still having pain.

To my knowledge one of the largest available study, thus far, on the efficacy of non-surgical disc decompression was the data compiled by Gose, Naguszewski & Naguszewski published in Volume 20 of the journal, Neurological Research. The data consisted of outcomes for 778 patients from 22 medical centers. These patients had their pain for an average of 40 months. 31 of these patients had previous low back surgery. The treatment consisted of 10-20 treatment sessions. 6 patients were excluded from the study because they improved before 10 treatments.

34 of the patients had extruded discs

195 had multiple disc herniations

382 had single disc herniations

47 had degenerative discs without herniations

19 had facet (joint) pain

31 of these 778 patients had previous low back surgery

RESEARCH SYNOPSIS

1) Bogduk, N,: The Anatomical Basis for Spinal Pain Syndromes. JMPT 6:Nov.Dec1995. There is no scientific basis for the belief muscles are a source of chronic pain. However controlled studies show how common disc and facet pain is accounting for more than 70% of chronic back pain.2) Komari H, et al.: The Natural History of Herniated Nucleus with Radiculopathy. Spine 21: 225-229, 1996 77 patients verified on pre-post MRI with signs and symptoms of herniation, underwent non-surgical intervention including pelvic traction. Changes in herniation and good-excellent symptomatic improvements were noted in over 82%. The authors draw the conclusion improving the disc’s contact with the blood supply accounts for healing of herniation.

3) Onel,D et. al.: CT Investigation of the effects of Traction on Lumbar Herniation. Spine 14: 82-90, 1989. 30 patients with lumbar herniations were tractioned in a CT scanner at >50% body weight for ~20 min. Hernia retraction occurred in 70% and good clinical improvements were seen in over 93%. The authors concluded improved blood flow was the source of healing. Additionally they speculated previous studies showing traction doesn’t create negative intradiscal pressures perhaps used too light a force.

5) Mathews, JA: Dynamic Discography: A Study of Lumbar Traction. Annals of Phys Med, IX (7), 265-279, 1968. 3 patients with a ruptured lumbar disc had contrast medium and radiographic images taken during and after a lumbar traction procedure. The protrusions were shown to lessen considerably with the 30 minute prone traction sessions and a dimpling of the outer annulus suggested a negative intradiscal force was created.

9) Constatoyannis C, et. al.: Intermittent Cervical Traction for Radiculopathy Due to Large-Volume Herniations. JMPT, 25 (3) 2002. Three weeks of the above described traction method to large volume hemiations resulted in complete resolution of symptoms in 4 patients.

10) Shealy N, Leroy P: New Concepts in Back Pain Management. AJPM (1) 20:239241 1998. The application of supine lumbar traction with adherence to several specific characteristics including progression to a peak force and altering the angle of ‘pull’ from 10 degrees (L5-S 1) to 30 degrees (L3) enhanced distraction at specific levels.

12) Weatherall VF: Comparison of electrical activity in the sacrospinalis musculature during traction in two different positions. J Ortho Sports Phys Ther(8):382-390, 1995. Through the use of EMG electrical activity was shown to be similar in the prone laying position vs. the supine position in a group of patients.

17) Dietrich Met al: Non-linear finite element analysis of formation and treatment of disc herniation. Proc Inst Mech Eng; 206(4):225-31, 1992. The author’s analysis shows loads not greater than those occurring in everyday life cause loss of stability of the disc and allow lateral nucleus displacement. The model indicates conservative therapy by traction may result in retraction of hernia by about 40%.

Clinical studies have shown Decompression Therapy to be extremely effective in treating back pain. In a recent study published in Orthopedic Technology Review Decompression Therapy was shown to be 86% effective in treating hemiated and degenerative discs. Not only that, but another study published in Anesthesiology News showed that after 4 years over 91 % remained pain free.OTHER STUDIES THAT SHOW JUST HOW EFFECTIVE DECOMPRESSION THERAPY IS

In the Journal of Neurological ResearchVOL 20, NO 4, April 1998 the researchers stated: “We consider decompression therapy to be a primary treatment modality for low back pain associated with lumbar disc herniation at single or multiple levels, degenerative disc disease, facet arthropathy, and decreased spine mobility. Physiology (pain and mobility) and pathology correlate imprecisely. We believe that post-surgical patients with persistent pain or ‘Failed Back Syndrome’ should not be considered candidates for further surgery until a reasonable trial of decompression has been tried.”

In the Journal of Neurological Research VOL 23, NO 7, October 2001 the researchers stated: “For any given patient with low back and referred leg pain, we cannot predict with certainty which cause has assumed primacy. Therefore surgery, by being directed at root decompression at the site of the hemiation alone, may not be effective if secondary causes of pain have become predominant. Decompression therapy, however, addresses both primary and secondary causes of low back and referred leg pain. We thus submit that Decompression therapy should be considered first, before the patient undergoes a surgical procedure which permanently alters the anatomy and function of the affected lumbar spine segment.”

In that same Volume of the Journal of Neuroloaical Research the Senior Lecturer in Orthopedics at Sydney University stated “Successful reduction of intradiscal pressures with decompression therapy represents a technological advance in lumbar spinal treatment and is likely to affect both the biomechanical and biochemical causes of discogenic pain.